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Toothache or pain in the mouth often comes from a dental disease. Sometimes, however, it is not the teeth themselves, but the tooth holding apparatus that causes the pain. Sore throat is one of the most common causes. This inflammation may have been preceded by a dental disease, but this is not necessarily the case. Find out more about possible causes and suitable treatment measures here.
As an essential part of the tooth retention system, the jaw (Gnathos) essential for daily food intake. The teeth are fixed in it, for anchoring them special tooth pockets sunk into the jaw (so-called alveoli) exist. These alveoli are present in the upper and lower jaw in equal numbers. The two jaw elements together form the Oral cavity (Cavum oris proprium) and thus make any eating, swallowing and speaking function possible in the first place. Despite these similarities, the individual function of the two jaw halves is not entirely identical.
For example, only the upper jaw (Maxilla) the Maxillary sinus (Maxillary sinus). On the one hand, the alveoli of the maxillary molars are predisposed. On the other hand, it also flows into the maxillary sinus Maxillary nerve (Maxilliaris nerve), which is used for the sensitive supply of the maxillary teeth. Furthermore, the maxillary sinus is above the Nose-jaw opening (Apertura nasomaxillaris) in direct connection with the nasal passage. An anatomical peculiarity that plays a special role with regard to jaw infections. In general, the upper jaw acts as a section of several vaulted bones on the face, through which such an inflammation can creep in, as it is not only part of the oral cavity, but also that Eye socket (Orbit) and the Nasal cavity (Cavum nasi). In both cases, the bulges provide theoretical entry points for infection germs, which then set the inflammatory process in motion.
At the Lower jaw (Mandible) it is a little different. According to the name, it is the lower part of the jaw and, in contrast to the upper jaw firmly anchored in the skull, can move freely. He shapes it chin (Mentum), the jaw (Bucca) and initiates the movement impulse of the jaw during chewing and speaking movements. For this purpose, the horseshoe-shaped mandible is in the back area over the Temporomandibular joint (Articulation temporomandibularis) hung on the side of the skull. The joint is surrounded by a series of muscles that allow jaw movement. In addition, there are some other muscle sections from the lower jaw, which are important for facial expressions and lip movements. Overall, the jaw muscles include:
- Chewing muscles - As the name already shows, this muscle section is responsible for the chewing movement and thus the movement of the lower jaw towards the upper jaw. The associated muscles run on the outside of the jaw and include
- Chewing muscle (Masseter muscle),
- Temple muscle (Temporalis muscle),
- Inner wing muscle (Pterygoideus medialis muscle),
- Outer wing muscle (Lateral petrygoideus muscle).
- Jawbone muscle (Mylohyoid muscle) - On the inside of the lower jaw extends the jaw-tongue muscle, which enables the lowering or opening of the jaw and the raising of the tongue.
- Corner of the mouth puller (Depressor anguli oris muscle / triangularis muscle) - This muscle originates from the lower jaw in the area of the corner of the mouth and pulls the corner of the mouth down true to the name.
- Lower lip puller (Depressor labii inferioris muscle) - This muscle is used to pull down the lower lip, which springs from the lower jaw on the side of the chin.
- Chin muscle (Mentalis muscle) - Located directly in front of the chin, this muscle allows the chin to wrinkle and push the lower lip upwards.
- Cheek muscle (Buccinator muscle) - This muscle originating in the cheek area has a particularly versatile function. On the one hand, it enables the jaw to transport the food porridge from the oral cavity back to the center of the oral cavity when chewing. On the other hand, the cheek muscle also has tasks in the area of facial expressions, since it is involved in activities such as laughing, whistling or blowing.
In order to sensitively supply all of these muscle activities, as well as the teeth of the lower jaw, a series of nerve strands are of course required. Your entry into the lower jaw structure is partially via the Lower jaw hole (Mandibular foramen), which runs on the inside of the lower jaw and conducts blood vessels supplying the jaws in addition to muscles. The nerves that run along the lower jaw can also be involved in inflammatory processes. The most important nerve structures are here
- Mandibular tooth nerve (Inferior alveolar nerve),
- Mandibular nerve (Mandibular nerve),
- Cheek nerve (Buccal nerve),
- Wing nerve (Pterygoide nerve),
- Chewing muscle nerve (Masseteric nerve),
- Ear temporal nerve (Auriculotemporalis nerve),
- Jawbone nerve (Mylohyoid nerve),
- Tongue nerve (Lingual nerve),
- Facial nerve (Facial nerve),
- Triplet nerve (Trigeminal nerve).
If one of these nerves is inflamed, be warned of the sometimes very strong pain symptoms. Because of the complex networking of the nerve strands, the pain sometimes radiates far, which can also make it difficult to locate the focus of the inflammation.
Inflammation of the jaw
An inflammation of the jaw usually arises as a consequence of an existing infection. The cause of this is often a pre-infection of the teeth or gums by pathogens, ie
- or mushrooms.
If inflammation of the gums or gums remains untreated, the pathogens quickly expand from the original source of the inflammation in the mouth to deep into the jawbone. In addition, other sources of infection far away from the tooth-holding apparatus are also conceivable as the cause of the inflammation. Depending on which part of the jaw is affected, there are three main types of jaw infection, namely
- Ostitis – Inflammation of the vascular canals in the area of the jaw,
- Periostitis – Inflammation of the jaw bone skin
- and Osteomyelitis – Inflammation of the bone marrow.
Dental and gum disease as the main cause
All too common dental diseases such as are well known as the cause of jaw infection Caries. The disease, which is also known as tooth decay, initially damages the enamel, but without suitable counter-treatment, it very quickly passes from the visible part of the tooth to the tooth root underneath it in the gums. Once there, caries provokes a creeping, bacterial inflammation of the tooth root, which is accompanied by pus formation and severe pain.
If the inflammation remains untreated, degenerative processes such as gum loss may also occur, which increases the risk of tooth loosening. In this case, medicine also speaks of Periodontitis. In addition, an expansion of the focus of inflammation to the gums and jawbones in this advanced stage of the disease can no longer be ruled out. The caries bacteria are carried away, which can manifest themselves in a variety of secondary inflammations. In this context, the following tooth and gum diseases in particular subsequently lead to an inflammation of the jaw:
- Inflammation of the teeth (Periodontitis),
- Inflammation of the tooth (Pulpitis)
- and Inflammation of the gums (Gingivitis).
In most cases, such inflammation is based on poor oral hygiene. If you do not brush your teeth regularly, you are not only laying the foundation for tooth decay, but you are also negligent in increasing the risk of jaw infection. A special risk for the jaw in dental diseases is also caused by so-called odontogenic infections. They develop in the course of periodontitis on the tooth or tooth holder and can cause an inflammatory jaw abscess.
Typical pathogens that lead to such an infection are usually the same that also contribute to a conventional tooth or gum disease. Which includes
- Streptococci (especially Streptococcus mutans),
- Staphylococci (especially Staphylococcus aureus),
- Campylobacter (especially Campylobacter rectus),
- Eikenella corrodens,
- Porphyromonas gingivalis
- and Prevotella intermedia.
Caution: There is a particular risk of jaw infection if a wisdom tooth is pre-infected. Since wisdom teeth extend particularly deep into the jaw, an expansion of the focus of inflammation is very common here. The inflamed wisdom tooth is often misplaced here (e.g. tilt) ahead, due to which the tooth cannot completely break through. For this reason, wisdom teeth that cause long-term problems should always be examined by a dentist.
Inflammation of the jaw due to ENT diseases
Due to the direct connection of the upper jaw to the nasal cavity, the pathogens of an ENT disease also get into the jaw structures, where they then trigger a subsequent inflammation. For example, an inflammation of the jaw through sinusitis is conceivable (Sinusitis). And even cold and flu pathogens can, if not fully cured, immigrate to the jaw and cause inflammatory infections there.
Inflammation from jaw injury
Inflammation of the jaw caused by violence is often underestimated. Mechanical violent effects, such as those that arise during a jaw operation, should be mentioned above all. The open wounds on the gums are usually very large and offer germs optimal access to the jaw structures if sterility is not maintained. The risk of wound infection in the jaw area is also very high when pulling wisdom teeth. The inflammation can reach extremely deep here, as the surgical procedure leads to an open cavity in the alveoli.
Otherwise, inflammatory jaw injuries can result from physical disputes or accidents. For example, a broken jaw due to blows or a violent impact is conceivable. Inflammation of the jaw vessels, as is typical for ostitis, is very easy to develop in this way.
The risk of inflammation of the jaw in the case of wounds is further increased by the influence of harmful substances such as nicotine or chemical drugs. The irritants can in themselves cause various inflammations in the mouth. If a wound is added, the risk of inflammation is all the higher.
Circulatory disorders are also mentioned, which can be triggered not only by intoxicants and stimulants, but also by existing heart and vascular diseases. If the jaw is not adequately supplied with blood, the jaw tissue tends to react to the lack of nutrients with inflammation, if not with jaw necrosis.
In addition to severe pain caused by irritated jaw nerves caused by inflammation, other accompanying symptoms such as pus formation or chewing problems also occur with an inflammation of the jaw. If the inflammation is not treated in a row, there is also a risk of weakening the function of the alveoli and thus loss of teeth. In the worst case, there is even necrosis of the jaw. Jaw infections can be acute or insidious.
Especially in the case of a gradual course, the symptoms initially resemble flu or colds and often conceal the actual disease value at this stage. Those affected complain of fatigue, runny nose and fever. And even if slight pain begins in the area of the jaw at this stage, it is often associated with a problem in the sinuses.
The symptoms only become more specific and indicate the actual cause of the symptoms as the disease process progresses or in the acute course of an inflammation of the jaw. Then the following symptoms appear:
- Pain: The formerly slight pain intensifies and becomes pungent or throbbing. They often occur directly at the scene. But they can also manifest themselves as pain in the ears, toothache or pain in other areas of the face. In the case of a chronic course, it is not uncommon for the pain situation to show up only in phases and to subside again and again. This peace is tricky, however, because the pathogens can spread even in the absence of pain in the jaw and cause further foci of inflammation.
- Swelling: If the jaw infection is caused by carious teeth, there may be minor swellings in the area of the oral mucosa, for example on tooth pockets. Larger abscess areas can also form in the oral cavity. Advanced jaw infections are often accompanied by pronounced swelling of the cheeks, which can then be red and very sensitive to pressure.
- Irritation of surrounding nerve pathways: Numerous nerve tracts run along the jawbones, which can also be affected by inflammation. Nerve pathways irritated in this way are therefore expressed in toothache and sensations. In particularly severe cases, it can even lead to paralysis and failure symptoms in the area of the entire facial motor skills and sensitivity.
- Symptoms after dental surgery: Jaw infections can often occur after (major) dental surgery. In these cases, in addition to the symptoms mentioned above, they also show up
- Loosening in the tooth retention apparatus,
- Toothache beyond what is expected,
- Wound healing disorders
- and pus formation.
An inflammation of the jaw can usually not be proven by pure eye diagnosis and anamnesis. In laboratory blood tests, too, only with increased inflammation values (CRP, blood count, blood sedimentation rate) is there a first focus that inflammation is taking place in the body, but without any indication of where it occurs. This is why imaging diagnostics are absolutely necessary, especially to be able to assess the extent of the inflammation and, if necessary, the infestation of other structures. The following imaging methods are therefore used to support the suspected diagnosis:
- Computed tomography
- and magnetic resonance imaging.
If the inflammation of the jaw manifests itself by festering abscesses in the oral cavity, a smear can be taken from it. Using microbial examination techniques, the latter can identify the causative pathogens in order to be able to start an adapted antibiotic treatment.
Since tumors can also cause an inflammation of the jaw in very rare cases, this is usually followed by further diagnostics. The goal is to locate the primary tumor and any metastases. In skeletal scintigraphy, the affected person is given a contrast medium through the vein, which is enriched in the bone areas with a high metabolic rate. These areas provide information about cancer and can be made visible using special camera technology. Following this diagnosis, a biopsy is also often performed in order to clarify the origin of the degenerated cells and to be able to adapt an effective therapy regime.
Acute and chronic jaw infections should be treated with medication after the diagnosis and the course of healing should be closely monitored, as otherwise life-threatening complications can be expected. According to their nature, untreated inflammations mainly spread along anatomical structures. The jaw itself is in a very close anatomical position to the brain, cranial nerves and blood circulation. Therefore, jaw infections can spread to the cranial nerves or even in the brain skull and lead to cranial nerve failures or meningitis. It is also possible for the pathogens to enter the blood vessel system, which can cause inflammation of the heart muscle (Myocarditis) or generalized blood poisoning (sepsis) cause.
Drug treatment for jaw infection has two main objectives. On the one hand, the patient's pain must be alleviated, which can sometimes be extremely painful during inflammatory processes in the jaw. On the other hand, it is of course important to stop the causative inflammatory pathogens and to counter them with suitable active ingredients.
Pain relievers are usually used here for pain relief, which can be administered in tablet form and dock onto the respective pain receptors via the bloodstream. Medicines such as ibuprofen, diclofenac or novalgin are the first choice for jaw infections in this regard. The medication also has an anti-inflammatory effect, which is an additional bonus for the treatment.
If the inflammation of the jaw has already made its way out and is noticeable through open, swollen and sometimes also suppurating wound pockets, you can also work with locally acting gels, sprays and mouthwash solutions. These drugs contain a germ-reducing (antiseptic) and a pain reliever (anesthetic) Active component. Chlorhexamed rinsing solution, octenidol rinsing solution, dynexan gel and xylocaine spray are typical drugs in this category.
In most cases, however, the antiseptic effect of the drugs mentioned is not sufficient to prevent the pathogens (mostly bacteria) to fight sufficiently. For this reason, treating physicians usually use antibiotic treatment. If the actual bacterial strain is known, the treatment can be adjusted accordingly and the most effective antibiotic can be used. The bacterial strain is sometimes unknown, which is why a common broad-spectrum antibiotic is often used here. The treatment can be carried out in tablet form or via infusion solutions. In the case of abscesses in the maxillary sinus, it is advisable to introduce the antibiotic active ingredients directly into the abscess cavity via cotton tamponades so that they can work immediately on site.
Inflammation of the jaw is usually treated with antibiotic therapy. To support this therapeutic measure, the person affected can use similar behaviors to those with flu or colds. This includes first and foremost ensuring that the body receives sufficient periods of rest with little stress and a sufficient amount of fluid.
In addition, the person concerned can also use external curd wrap. To do this, spread curd cheese on a textile surface and lay it on the face skin in the affected area of the jaw for 10-15 minutes. The curd used should not be used directly from the refrigerator, but should be warmed to room temperature. Even in this condition, the curd wrap has a cooling effect on the painful focus of inflammation and can alone bring relief. It is much more important, however, that curd cheese also has an anti-inflammatory effect in these temperature ranges.
Sometimes affected people can not endure curd wrap with a jaw infection, because the pressure caused by the curd coating can intensify the pain. In this case, you can try whether red light therapy with a red light lamp brings relief. To do this, sit in front of an infrared lamp at a distance of at least 30 centimeters for 10 to 15 minutes. Such a session can be repeated two to three times a day. The infrared radiation has a local anti-inflammatory effect.
In acute pain caused by the inflammation, preparations with arnica extracts can be pain-relieving. These can be used orally as globules or as a tincture, or they can also be used externally as creams and ointments containing creams and ointments.
The use of medicinal herbs can vary in the case of an inflammation of the jaw. Inhaling herbal vapors as well as drinking herbal teas, rinsing with herbal water or chewing anti-inflammatory or pain-relieving herbs have a supporting effect here. Classic medicinal plants that are used for this purpose are
- Johannis herbs,
- and sage.
For inhalation, simply add a little chamomile, peppermint or sage to a pot of hot water. The person concerned can carry out inhalation therapy three to four times a day for about ten minutes and thus contain the inflammatory reaction, make pus flow away and moisten the mucous membranes.
Both dried cloves and fresh garlic are thought to have anti-inflammatory effects. Careful chewing of dried cloves or fresh pieces of garlic can be used as a relief if the inflammation is caused by carious or otherwise damaged teeth.
An herbal infusion of sage, peppermint, St. John's wort or chamomile can not only be drunk as a soothing tea for pain relief. The cold pull-out is also ideal for mouthwashing. The prerequisite is, of course, that the herbal broth does not contain sugar, as this is an additional breeding ground for bacteria and can aggravate existing inflammation wounds.
From the field of Schüßler therapy, Schüßler Salt No. 7 (Magnesium phosphoricum) as "hot seven" to apply to tackle the acute pain situation. Unless otherwise prescribed, three to five tablets are dissolved and drunk in a glass of hot water two to three times a day. The Schüßler Salt No. 7 should also have an anti-inflammatory effect. The same applies to preparations such as Belladonna and Hepar sulfuris, which are supposed to support the body in the fight against inflammation as a daily use of globules (approximately three to five globules).
Surgical treatment for jaw infections can be considered under the following conditions:
- the herd of pathogens can no longer be controlled with medication,
- the inflammation has already spread to surrounding tissue,
- the inflammation has progressed to the point where it begins necrosis (Tissue sunset) on the jawbone
In order to be operational, it is necessary to find the location of the pathogen. Meaningful imaging diagnostics are therefore required before surgical treatment. Sometimes the cause of the inflammation may be further away from the location of the inflammation. For example, carious teeth can cause massive jaw inflammation. In such a case, often only the surgical extraction of the affected tooth can provide relief. Rejection of foreign material from the body can also occur during dental implantation. In this case, too, often only the surgical removal of the previously implanted material helps.
Further surgical measures deal with the surgical removal of abscesses and cysts and with the removal of jaw bone necrosis and tumorous tissue. If the focus of the treatment is curative therapy for jaw bone cancer or jaw bone metastases, very spectacular operations are carried out, which are accompanied by the removal of the affected part of the jaw and a reconstruction of the jaw bone. Bone parts from your own body, for example a rib, are often used for the reconstruction, since experience has shown that rejection reactions are less common.
Diseases of inflammation of the jaw: caries, periodontitis, gingivitis, inflammation of the roots, inflammation of the sinuses, cold, flu. (ma)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- M. R. Kanth et al .: Efficacy of Specific Plant Products on Microorganisms Causing Dental Caries, in: Journal of Clinical and Diagnostic Research, Volume 10, Issue 12, December 2016, PubMed
- David F. Murchison: Toothache and Infections, MSD Manual, (accessed January 22, 2020), MSD
- Thomas Weber: Memorix Zahnmedizin, Thieme Verlag, 5th edition, 2017
- Hans-Peter Müller: Periodontology, Thieme Verlag, 3rd edition, 2012
- Jochen Jackowski, Hajo Peters, Frank Hölzle: Dental surgery, Springer Verlag, 1st edition, 2017
- Thomas Lenarz, Hans-Georg Boenninghaus: ENT, Springer-Verlag, 14th edition 2012
ICD codes for this disease: K10.2ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.